The foot was in a pronated position planted and the force of the impact causing external rotation of the limp on that planted foot resutls in disruption of the deltoid ligament medially, tears of the anterior and posterior tibia-fibular ligaments, disruption of the tibia-fibula syndesmosis and ending with a high fibular fracture (both top images). This injury requires open reduction with internal fixation in order to re-align the fractured bones and prevent disability (Bottom left).īelow is case of a fracture of the ankle classified as PER IV injury meaning pronation with external rotation. The fractures can be seen from a view at the top of the foot (left) and side of the foot (right). In the x-rays below there are fractures seen in the midtarsal bones that can occur with a high impact twisting injury where the foot is caught in something like the stirrup of a horse saddle or from direct high impact traums to the middle of the foot.
We bore a hole in the bone at the prior screw sites, added two syndesmotic screws that went across both bones for added stability as well as 2 Arthrex tightopes. On the Post operative films by our physicians, the space between the medial malleolus and talus is decreased and the joint is congruent and symmetrical. This is Pre and Post op xrays of surgical correction of a syndesmotic rupture that failed the first time by a different physician due to screw break. Complete reduction and fixation can be seen in the last pic. The Widening of the Lis Franc joint can be seen on the first pic and second magnified pic. Pre and Post-op X-rays Status Post ORIF Lis Franc Fracture/Dislocation.
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